NO SOUVENIRS

Nell'idea che per storia si affronti sempre un confronto tra due differenti realtà spaziali e temporali, occupandoci della Storia di una Disciplina oggi attuale, decidiamo di pubblicare un articolo che si rifà assolutamente ai nostri giorni.

Pur andando ricercando infatti negli archivi più polverosi spunti utili per i nostri approfondimenti, spesso molte cose interessanti si trovano sulla nostra scrivania in una rivista settimanale e internazionale come Time.

L'articolo che di seguito pubblichiamo, è stato infatti pubblicato su Time nel mese di Maggio 2009. Quello che troviamo interessante, è come possa essere differente oggi la Chirurgia, disciplina che in passato, fino a meno di 200 anni fa, non raggiungeva la dignità intellettuale della medicina,

venendo spesso relegata ad artigiani, barbieri e cavadenti, contornata da un' elevata mestizia e mortalità.

In quest'articolo leggiamo infatti il più ultimo ausilio tecnologico per scongiurare il pericolo che una benda o altro possano rimanere nella nostra pancia dopo un intervento. Un tempo il più grande augurio che si potesse chiedere, invece, prima di un intervento chirurgico, era di non morire sotto i ferri o rimanere gravemente mutilati. L'arte del chirurgo era correlata con la capacità di tagliare in quanto meno tempo possibile, non con la finezza dell'operazione. I chirurghi sfoggiavano camici sporchi di sangue, onore e merito accumulato dopo anni e anni di esperienza, mentre oggi l'antisepsi richiede una rigida pulizia del campo, con utilizzo di materiale pressoché sterile. Colpisce quindi quanto sia cambiato l'approccio alla chirurgia, l'esito della stessa, se oggi un sistema con onde radio è messo in pratica per evitare il rischio di dimenticare qualcosa nella pancia. Un cambiamento radicale, sia nelle tecnologie impiegate, sia nell'aspettativa dell'intervento, nel suo successo, che lascia svettare la Chirurgia nella vetta più alta dell'innovazione e nel successo della medicina. E pensare che Ippocrate richiedeva che si giurasse di non effettuare operazioni chirurgiche per i calcoli, tanto erano pericolose e dolorose.

Riportiamo l'articolo in inglese, lingua ecumenica al nostro secolo della scienza, oltre che originale dell'articolo, comunque reperibile sul sito originale del Time.

Patients who undergo surgery aren't keen on souvenirs. Most draw the line at a scar. But some will go home with an internal takeaway — a surgical sponge left inside them. The majority of U.S. hospitals still use traditional sponges that nurses count manually. (They also count instruments.) But an increasing number have switched to more technologically sophisticated sponge systems that automate the counting to enhance patient safety.

This spring, Memorial Sloan-Kettering Cancer Center (MSKCC) in New York City became the first hospital to switch to the SmartSponge System — a technology that features chip-embedded sponges — created by ClearCount Medical Solutions, a five-year-old company in Pittsburgh, Pa. It relies on radio-frequency identification (RFID) technology. "Ours is the only FDA-cleared system that uses radio-frequency identification to both count and locate surgical sponges," says David Palmer, ClearCount's CEO. He expects revenues to reach $8 million this year and $27 million in 2010.

Using ClearCount's system, nurses scan packages of sponges before an operation. The technology verifies and counts each sponge's internal chip, recording the total in an In column on a display monitor. Used sponges are tossed — either singly or in a compressed wad — into a receptacle with a built-in sensing device that again verifies each chip and tallies the Outs. Ideally, the figures in those two columns match. If not, the number of missing sponges appears in a third column, aptly titled Find. That's a signal to spring for the wand, which digitally homes in on sponges still inside the patient.

For surgical nurses charged with counting sponges, the device has promise. "Nurses are willing to embrace new technology as long as it doesn't complicate their work flow or compromise the timing and sequence of their counting," says Steven Fleck, ClearCount's co-founder and CTO. At MSKCC, the prospect of improved patient safety and work efficiency won over Michelle Burke, director of perioperative services, and her staff. "One surgeon even tested the detection system for himself by hiding sponges in a corner of the operating room, and the technology located them," says Burke, who bought 21 of the $15,000 devices.

Large hospitals house 20 to 30 operating rooms and go through hundreds of thousands of sponges a year. Burke acknowledges that adopting the system will significantly escalate sponge costs, but for hospitals there's a cost-benefit trade-off. Using ClearCount sponges increases the cost of each surgical procedure by an average of $30. Yet the cost of surgical miscues may make the use of systems like ClearCount's a relative bargain. In 2008 the Centers for Medicare and Medicaid Services stopped reimbursing hospitals for some of the patient care tied to preventable complications, like those caused when objects are left inside patients during surgery. "Many hospitals have begun to more seriously address these 'never events' — as in 'never should happen,'" says ClearCount's Palmer. "There is a high cost — delays in the surgical schedule, as well as litigation and bad publicity — when hospitals do not take proactive measures."

At a hospital where 30,000 operations are performed a year, having three or four of these incidents annually is not uncommon, says Dr. Atul Gawande, a surgeon at Brigham and Women's Hospital in Boston, who has researched medical errors linked to surgical sponges. "Our studies show that automated sponge-counting systems make things markedly safer," he says. He believes these systems will be standard within five or 10 years.

ClearCount is banking on it. During the past year, the company has sent its SmartSponge System for evaluation to three dozen hospitals, several of which have committed to buy it. The company expects a similar response next year when it expands globally.

Sponges are yet another promising area where RFID has popped up in hospitals. ClearCount plans to expand its tracking to surgical instruments. And more applications await — for instance, ensuring that blood products are delivered with complete accuracy by equipping patients with an RFID device. After all, the first rule of medicine is to do no harm.